Prolonged use of Beta Blockers does not improve post MI treatment outcomes

Prolonged use of Beta Blockers does not improve post-heart attack treatment outcomes, revealed a study published in the Circulation: Cardiovascular Quality and Outcomes.

Beta-blocker therapy is given to patients suffering from acute myocardial infarction/heart attack. The therapy is believed to reduce mortality in these patients. Recently beta-blocker therapy has become a hot topic in the medical fraternity as few studies have questioned the benefit of prolonged duration of the beta-blockers post-heart attack.

The authors studied patients ≥65 years of age with MI, discharged on beta-blocker therapy and alive 3 years later without a recurrent MI to evaluate beta-blocker use and dose (none, <50%, and ≥50% of the recommended target) at 3 years using data from the CRUSADE Registry (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the American College of Cardiology/American Heart Association Guidelines) linked with Medicare claims.

The authors then examined the adjusted association between beta-blocker use (and dose) at 3 years and the cardiovascular composite of all-cause mortality, hospitalization for recurrent MI, ischemic stroke, or heart failure over the subsequent 5 years. Of the 6893 patients ≥65 years age, β-blocker use at 3 years was 72.2% (n=4980); 43% of these were treated with ≥50% of the target β-blocker dose using an inverse probability of treatment weighting.

Key findings

• β-blocker use was not associated with a significant difference in the composite outcome.


• Neither low dose (<50% target dose) nor high dose (≥50% target dose) β-blocker use was associated with a significant difference in risk when compared with no β-blocker use.


• Results were also consistent in patients with and without heart failure or systolic dysfunction.

To conclude the study the authors wrote: "In this observational analysis, β-blocker use beyond 3 years post-MI, regardless of the dose achieved, was not associated with improved outcomes. The role of prolonged β-blocker use, particularly in older adults, needs further investigation."

In the majority of patients who are getting older, there are side effects of therapy, so if you're thinking of deprescribing, maybe beta-blockers should be one of the drugs you consider deprescribing early because there is no association with better long-term outcomes," authors said.

For further reference, click on the link

https://doi.org/10.1161/CIRCOUTCOMES.118.005103